PINE ISLAND DERMATOLOGY, LLC
NPI 1508580200
Dermatology in Palm Beach Gardens, FL

Active since September 27, 2022
3365 BURNS RD STE 217, PALM BEACH GARDENS, FL 33410(772) 485-5574 Get Directions Write a Review

NPPES record last updated: September 27, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pine Island Dermatology, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE ISLAND DERMATOLOGY, LLC (NPI 1508580200) is a healthcare organization registered as a dermatology in Palm Beach Gardens, Florida and active in the NPI registry since September 2022. The organization lists Sergey Arutyunyan, Dermatologist/president, as its authorized official.

NPPES Registry Identity

NPI1508580200
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePINE ISLAND DERMATOLOGY, LLC
Location Address3365 BURNS RD STE 217Palm Beach Gardens, FL 33410-4312
Mailing Address9118a Sw 20th CtDavie, FL 33324-5074 · (177) 248-5557
Organization SubpartNo
Authorized OfficialSergey ArutyunyanDermatologist/president · (772) 485-5574
Enumeration DateSeptember 27, 2022
NPPES CertifiedSeptember 27, 2022
✔ NPI 1508580200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
3365 BURNS RD STE 217, Palm Beach Gardens, FL 33410

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pine Island Dermatology, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pine Island Dermatology, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1295274843
7031 SW 62ND AVE
South Miami, FL 33143
(305) 284-7761
✔ PECOS✔ Accepts Medicare79 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2276172

Pine Island Dermatology, LLC · Palm Beach Gardens, FL
Expired · Oct 1, 2026
CLIA Number10D2276172
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorSergey Arutyunyan
Laboratory Phone(561) 567-8899
Laboratory LocationPine Island Dermatology, LLC3365 Burns Rd Ste 217, Palm Beach Gardens, FL 33410
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Island Dermatology, LLC's NPI number?

The NPI number for Pine Island Dermatology, LLC is 1508580200. It was assigned to this organization in the NPPES registry on September 27, 2022.

Where is Pine Island Dermatology, LLC located?

Pine Island Dermatology, LLC is located at 3365 Burns Rd Ste 217, Palm Beach Gardens, FL 33410. The listed phone number is (772) 485-5574.

What is Pine Island Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Pine Island Dermatology, LLC enrolled in Medicare?

Yes. Pine Island Dermatology, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pine Island Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Pine Island Dermatology, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pine Island Dermatology, LLC was last updated on September 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.